May 2018

This week the Congressional Budget Office (CBO) released updated estimates of their baseline projections of the federal costs for premium subsidies under the Affordable Care Act for the 2018 to 2028 period. A few key takeaways: CBO previously estimated that repealing the mandate would reduce coverage by 13 million in 2027 and has now revised its estimate to around 8.7 million. Furthermore, CBO estimates that premiums will be “about 10 percent higher in 2019" because of the individual mandate repeal. For insights into CBO’s updated health insurance model, consider tuning in to a presentation on June 19 by CBO staff at the Bipartisan Policy Center which will be followed by a panel of budget and health care policy experts sharing their initial reactions to the proposed changes to the model.

This week State Health and Value Strategies (SHVS) published Medicaid Buy-In: State Options, Design Considerations and Section 1332 Waiver Implications, which explores opportunities for states to leverage their Medicaid programs to strengthen coverage. SHVS hosted a companion webinar on Tuesday (if you missed it, you can download the slide deck and the recording) and has created a map to track state activity around Medicaid buy-in programs. The map includes links to relevant legislation and groups states by whether they are pursuing a buy-in program or have established a task force to study the impact of a buy-in program.

Today President Trump gave a much anticipated speech on reducing the cost of prescriptions drugs and released American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. The blueprint outlines actions that the Department of Health and Human Services (HHS) will take including advancing generics to increase competition and exploring changes to the Medicaid Drug Rebate Program rules. Also this week, the Centers for Medicare & Medicaid Services (CMS) released its Rural Health Strategy, an interagency effort that seeks to improve access and quality of care for rural Americans.

Secretary of Health and Human Services Alex Azar addressed the World Health Care Congress this week and focused his remarks on value-based care and the role of the Department of Health and Human Services (HHS) in transforming the health care system in the United states “into one that pays for value.” Azar outlined four areas of emphasis for HHS: health information technology; health care pricing transparency; new models in Medicare and Medicaid; and reducing barriers to care coordination.